247. ALBUMIN AND DERIVED NEUTROPHIL-TO-LYMPHOCYTE RATIO IS A NOVEL PROGNOSTIC FACTOR FOR PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Various nutritional and inflammatory biomarkers have been reported to be associated with cancer prognosis, but most studies have focused on conditions before neoadjuvant chemotherapy (nCT). Developing real-time biomarkers reflecting changes in systemic conditions during nCT is important. We established a novel biomarker, represented as the albumin to derived neutrophil-to-lymphocyte ratio (Alb-dNLR ratio), and calculated the change in Alb-dNLR ratio (ΔAlb-dNLR) during nCT. We aimed to evaluate whether ΔAlb-dNLR is associated with prognosis in ESCC patients. We investigated 172 patients who underwent nCT before esophagectomy between April 2010 and March 2018. dNLR was calculated as the ratio of neutrophil count to (white blood cell count—neutrophil count), Alb-dNLR ratio was calculated by dividing serum albumin level by dNLR, and ΔAlb-dNLR was evaluated by dividing the post-Alb-dNLR ratio by the pre-Alb-dNLR ratio. Patients were divided into ‘high’ and ‘low’ groups according to ΔAlb-dNLR. Thirty-nine patients (22.7%) had a low ΔAlb-dNLR (≤0.8). The 5-year overall survival (OS) rates in patients with low and high ΔAlb-dNLR were 38.1% and 53.6%, respectively (p = 0.0072). Multivariate analyses demonstrated that estimated blood loss (p = 0.044), pathological T stage (p = 0.0005), pathological N stage (p = 0.017), and ΔAlb-dNLR (p = 0.005) were independent prognostic factors for OS. ΔAlb-dNLR is a useful prognostic factor for OS in patients with ESCC receiving nCT.